Blaming Mass Shootings on Serious Mental Illness Has Harmful Effects, Says APA Past President

In the two weeks since a 19-year-old opened fire at Marjory Stoneman Douglas High School in Parkland, Fla., killing 17 students and faculty members, there has been much talk by politicians about the need to address untreated serious mental illness in the United States.

In an article published today in JAMA Psychiatry, APA Past President Renée Binder, M.D., and Matthew Hirschtritt, M.D., M.P.H., both of the University of California, San Francisco, wrote that while political rhetoric focusing the blame for mass shootings on individuals with serious mental illness may be “politically expedient,” such an approach “stigmatizes an already vulnerable and marginalized population, fails to identify individuals at the highest risk for committing violence with firearms, and distracts public attention from policy changes that are most likely to reduce the risk of gun violence.”

Binder and Hirschtritt summarized several studies that suggest serious mental illness is not a specific indicator for risk of violence. The article notes that such studies have found that people with mental illness are three times more likely to be victims than perpetrators of violence and only 4% of criminal violence in the United States can be attributed to people with mental illness.

Multiple factors other than serious mental illness contribute to violence risk, Binder and Hirschtritt wrote, including being male, young, having a history of perpetrating violence or being a victim of violence, and unlawful use of firearms. Certain triggers, including intoxication and severe stress, have also been shown to increase the risk of gun violence in people with and without mental illness.

“Addressing the risk of future mass shootings requires addressing a wide range of individual, community-level, and national and state policy factors, including decreasing access to guns, especially during periods of heightened violence risk,” they wrote. “Likewise, identifying and assisting those with serious mental illness requires the investment of resources and coordination of services, including supportive case managers, law enforcement and emergency personnel, and mental health clinicians.”

Psychiatrists should work to counter the perception that mental illness is the primary cause of gun violence, Binder told Psychiatric News. “I believe that psychiatrists have a role in advocacy and education. We have a responsibility in terms of educating people that guns are very dangerous, should be safely stored, and should be taken away from dangerous people,” she said. “Most people with mental illness will never commit a mass shooting, and this rhetoric leads to increased shame, societal reduction, stigmatization, and problems in gaining stable employment and housing.”

For related information, see the Psychiatric News Alert “APA Joins Other Physician Groups to Demand Action on Gun Violence.”

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APA Joins Other Physician Groups to Demand Action on Gun Violence

In the aftermath of Wednesday’s shooting that killed 17 students and staff members at Marjory Stoneman Douglas High School in Parkland, Fla., APA and four organizations representing 450,000 physicians and medical students called on President Donald Trump and Congress to take meaningful action against gun violence.

Joining with APA were the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, and the American College of Physicians.

“Gun violence is a public health epidemic that is growing in frequency and lethality, and it is taking a toll on our patients,” the groups said in a statement released today. “We urge our national leaders to recognize in this moment what the medical community has long understood: we must treat this epidemic no differently than we would any other pervasive threat to public health. We must identify the causes and take evidence-based approaches to prevent future suffering.”

The groups have asked the president and Congress to take the following actions:

• Label violence caused by the use of guns a national public health epidemic.
• Fund appropriate research at the Centers for Disease Control and Prevention as part of the FY 2018 omnibus spending package.
• Establish constitutionally appropriate restrictions on the manufacture and sale, for civilian use, of large-capacity magazines and firearms with features designed to increase their rapid and extended killing capacity.

While mass shootings attract much attention from the public and the media, the groups noted that current policies regarding access to guns in this country expose Americans daily to the risks of violent acts including suicide, homicide, and unintentional injury.

“The families of the victims in Parkland and all those whose lives have been impacted by daily acts of gun violence deserve more than our thoughts and prayers. They need action from the highest levels of our government to stop this epidemic of gun violence now,” the statement concluded.

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